Assessment of Safety and Glycemic Control During Football Tournament in Children and Adolescents With Type 1 Diabetes—Results of GoalDiab Study

2019 ◽  
Vol 31 (4) ◽  
pp. 401-407 ◽  
Author(s):  
Andrzej Gawrecki ◽  
Aleksandra Araszkiewicz ◽  
Agnieszka Szadkowska ◽  
Grzegorz Biegański ◽  
Jan Konarski ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Children And Adolescents ◽  
Insulin Dose ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Low Glucose ◽  
Lactate Levels

Purpose: To assess glycemic control and safety of children and adolescents with type 1 diabetes participating in a 2-day football tournament. Methods: In total, 189 children with type 1 diabetes from 11 diabetes care centers, in Poland, participated in a football tournament in 3 age categories: 7–9 (21.2%), 10–13 (42.9%), and 14–17 (36%) years. Participants were qualified and organized in 23 football teams, played 4 to 6 matches of 30 minutes, and were supervised by a medical team. Data on insulin dose and glycemia were downloaded from personal pumps, glucose meters, continuous glucose monitoring, and flash glucose monitoring systems. Results: The median level of blood glucose before the matches was 6.78 (4.89–9.39) mmol/L, and after the matches, it was 7.39 (5.5–9.87) mmol/L (P = .001). There were no episodes of severe hypoglycemia or ketoacidosis. The number of episodes of low glucose value (blood glucose ≤3.9 mmol/L) was higher during the tournament versus 30 days before: 1.2 (0–1.5) versus 0.7 (0.3–1.1) event/person/day, P < .001. Lactate levels increased during the matches (2.2 [1.6–4.0] mmol/L to 4.4 [2.6–8.5] mmol/L after the matches, P < .001). Conclusions: Large football tournaments can be organized safely for children with type 1 diabetes. For the majority of children, moderate mixed aerobic–anaerobic effort did not adversely affect glycemic results and metabolic safety.

scholarly journals Anxiety, depression, and glycemic control during Covid-19 pandemic in youths with type 1 diabetes

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Maria Cusinato ◽  
Mariangela Martino ◽  
Alex Sartori ◽  
Claudia Gabrielli ◽  
Laura Tassara ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Psychological Impact ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Well Being ◽  
Glucose Variability ◽  
Threshold Score ◽  
The Impact

Abstract Objectives Our study aims to assess the impact of lockdown during the coronavirus disease 2019 pandemic on glycemic control and psychological well-being in youths with type 1 diabetes. Methods We compared glycemic metrics during lockdown with the same period of 2019. The psychological impact was evaluated with the Test of Anxiety and Depression. Results We analyzed metrics of 117 adolescents (87% on Multiple Daily Injections and 100% were flash glucose monitoring/continuous glucose monitoring users). During the lockdown, we observed an increase of the percentage of time in range (TIR) (p<0.001), with a significant reduction of time in moderate (p=0.002), and severe hypoglycemia (p=0.001), as well as the percentage of time in hyperglycemia (p<0.001). Glucose variability did not differ (p=0.863). The glucose management indicator was lower (p=0.001). 7% of youths reached the threshold-score (≥115) for anxiety and 16% for depression. A higher score was associated with lower TIR [p=0.028, p=0.012]. Conclusions Glycemic control improved during the first lockdown period with respect to the previous year. Symptoms of depression and anxiety were associated with worse glycemic control; future researches are necessary to establish if this improvement is transient and if psychological difficulties will increase during the prolonged pandemic situation.

scholarly journals Liraglutide as additional treatment for type 1 diabetes

2011 ◽  
Vol 165 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Ajay Varanasi ◽  
Natalie Bellini ◽  
Deepti Rawal ◽  
Mehul Vora ◽  
Antoine Makdissi ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Insulin Dose ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Additional Treatment ◽  
The Body ◽  
The Mean ◽  
Bolus Insulin

ObjectiveTo determine whether the addition of liraglutide to insulin to treat patients with type 1 diabetes leads to an improvement in glycemic control and diminish glycemic variability.Subjects and methodsIn this study, 14 patients with well-controlled type 1 diabetes on continuous glucose monitoring and intensive insulin therapy were treated with liraglutide for 1 week. Of the 14 patients, eight continued therapy for 24 weeks.ResultsIn all the 14 patients, mean fasting and mean weekly glucose concentrations significantly decreased after 1 week from 130±10 to 110±8 mg/dl (P<0.01) and from 137.5±20 to 115±12 mg/dl (P<0.01) respectively. Glycemic excursions significantly improved at 1 week. The mean s.d. of glucose concentrations decreased from 56±10 to 26±6 mg/dl (P<0.01) and the coefficient of variation decreased from 39.6±10 to 22.6±7 (P<0.01). There was a concomitant fall in the basal insulin from 24.5±6 to 16.5±6 units (P<0.01) and bolus insulin from 22.5±4 to 15.5±4 units (P<0.01).In patients who continued therapy with liraglutide for 24 weeks, mean fasting, mean weekly glucose concentrations, glycemic excursions, and basal and bolus insulin dose also significantly decreased (P<0.01). HbA1c decreased significantly at 24 weeks from 6.5 to 6.1% (P=0.02), as did the body weight by 4.5±1.5 kg (P=0.02).ConclusionLiraglutide treatment provides an additional strategy for improving glycemic control in type 1 diabetes. It also leads to weight loss.

scholarly journals Sensor-Augmented Insulin Pumps and Hypoglycemia Prevention in Type 1 Diabetes

2016 ◽  
Vol 11 (1) ◽  
pp. 50-58 ◽  
Author(s):  
Isabelle Steineck ◽  
Ajenthen Ranjan ◽  
Kirsten Nørgaard ◽  
Signe Schmidt
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Insulin Pumps ◽  
Continuous Glucose Monitor ◽  
Insulin Suspension ◽  
Multiple Daily Injections

Hypoglycemia can lead to seizures, unconsciousness, or death. Insulin pump treatment reduces the frequency of severe hypoglycemia compared with multiple daily injections treatment. The addition of a continuous glucose monitor, so-called sensor-augmented pump (SAP) treatment, has the potential to further limit the duration and severity of hypoglycemia as the system can detect and in some systems act on impending and prevailing low blood glucose levels. In this narrative review we summarize the available knowledge on SAPs with and without automated insulin suspension, in relation to hypoglycemia prevention. We present evidence from randomized trials, observational studies, and meta-analyses including nonpregnant individuals with type 1 diabetes mellitus. We also outline concerns regarding SAPs with and without automated insulin suspension. There is evidence that SAP treatment reduces episodes of moderate and severe hypoglycemia compared with multiple daily injections plus self-monitoring of blood glucose. There is some evidence that SAPs both with and without automated suspension reduces the frequency of severe hypoglycemic events compared with insulin pumps without continuous glucose monitoring.

scholarly journals Glycemic Control and Blood Glucose Monitoring Over Time in a Sample of Young Australians With Type 1 Diabetes: The role of personality

Diabetes Care ◽  
2013 ◽  
Vol 36 (10) ◽  
pp. 2968-2973 ◽  
Author(s):  
D. Waller ◽  
C. Johnston ◽  
L. Molyneaux ◽  
L. Brown-Singh ◽  
K. Hatherly ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Over Time

scholarly journals Short-term use of continuous glucose monitoring system adds to glycemic control in young type 1 diabetes mellitus patients in the long run: A clinical trial

2011 ◽  
Vol 68 (8) ◽  
pp. 650-654 ◽  
Author(s):  
Gordana Bukara-Radujkovic ◽  
Dragan Zdravkovic ◽  
Sinisa Lakic
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Type 1 Diabetes Mellitus ◽  
Glucose Monitoring ◽  
Control Group ◽  
Short Term ◽  
Experimental Group

Background/Aim. Balancing strict glycemic control with setting realistic goals for each individual child and family can optimize growth, ensure normal pubertal development and emotional maturation, and control long term complications in children with type 1 diabetes (T1DM). The aim of this study was to evaluate the efficacy of short-term continuous glucose monitoring system (CGMS) application in improvement of glycemic control in pediatric type 1 diabetes mellitus (T1DM) patients. Methods. A total of 80 pediatric T1DM patients were randomly assigned into the experimental and the control group. The experimental group wore CGMS sensor for 72 hours at the beginning of the study. Self-monitored blood glucose (SMBG) levels and hemoglobin A1c (HbA1c) levels were obtained for both groups at baseline, and at 3 and 6 months. Results. There was a significant improvement in HbA1c (p < 0.001), in both the experimental and the control group, without a significant difference between the groups. Nevertheless, after 6 months the improvement of mean glycemia was noticed only in the experimental group. This finding was accompanied with a decrease in the number of hyperglycemic events and no increase in the number of hypoglycemic events in the experimental group. Conclusions. The results suggest that the CGMS can be considered as a valuable tool in treating pediatric T1DM patients, however further research is needed to more accurately estimate to what extent, if any, it outperforms intensive self-monitoring of blood glucose.

Significance of “Time below Range” as a Glycemic Marker Derived from Continuous Glucose Monitoring in Japanese Children and Adolescents with Type 1 Diabetes

2020 ◽  
Vol 93 (4) ◽  
pp. 251-257
Author(s):  
Tatsuhiko Urakami ◽  
Kei Yoshida ◽  
Remi Kuwabara ◽  
Yusuke Mine ◽  
Masako Aoki ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Target Range ◽  
Japanese Children ◽  
Mean Frequency ◽  
The Mean

<b><i>Introduction:</i></b> We evaluated the frequencies of various glycemic markers derived from continuous glucose monitoring in Japanese children and adolescents with type 1 diabetes and assessed the significance of hypoglycemia duration. <b><i>Methods:</i></b> We enrolled 85 children and adolescents (36 boys and 49 girls) with type 1 diabetes who used FreeStyle<sup>®</sup> Libre in the present study. Frequencies of blood glucose levels as time within target range (TIR; 70–180 mg/dL), time below target range (TBR; &#x3c;70 mg/dL), time below extreme hypoglycemia range (TBER; &#x3c;54 mg/dL), and time above range (TAR; &#x3e;180 mg/dL) were assessed during a 3-month study period. Furthermore, we evaluated the intraday frequencies of TBR and TBER. <b><i>Results:</i></b> The mean frequencies of TIR, TBR, and TAR were 52.7 ± 11.3%, 10.8 ± 5.4%, and 36.5 ± 10.8%, respectively, whereas the mean frequency of TBER was 1.1 ± 0.9% (0–3.0%); there was no clinical episode of severe hypoglycemia. The mean frequency of TBR was significantly greater in 0–6 h (16.9 ± 5.2%) than in 6–12 h (7.8 ± 2.9%) and 18–24 h (6.8 ± 4.8%; <i>p</i> &#x3c; 0.01) time zones, respectively. <b><i>Discussion/Conclusion:</i></b> We found similar TIR and comparatively higher TBR frequencies, particularly during sleep, than those that were previously reported. Possible reasons for the higher frequency of TBR include differences in the quality of insulin treatment and diabetes care between the present study and the European studies. The utilization of advanced technologies, such as a predictive low-glucose suspend-function pump or closed-loop therapy, can reduce the frequency of TBR, with a consequent increase in TIR frequency and comprehensive improvement in glycemic control.

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